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https://www.readbyqxmd.com/read/29352419/a-systematic-review-of-interventions-to-follow-up-test-results-pending-at-discharge
#1
Patrick J Darragh, T Bodley, A Orchanian-Cheff, K G Shojania, J L Kwan, P Cram
BACKGROUND: Patients are frequently discharged from the hospital before all test results have been finalized. Thirty to 40% of tests pending at discharge (TPADs) return potentially actionable results that could necessitate change in the patients' management, often unbeknownst to their physicians. Delayed follow-up of TPADs can lead to patient harm. We sought to synthesize the existing literature on interventions intended to improve the management of TPADs, including interventions designed to enhance documentation of TPADs, increase physician awareness when TPAD results finalize post-discharge, decrease adverse events related to missed TPADs, and increase physician satisfaction with TPAD management...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29351789/prevention-of-severe-infectious-complications-after-colorectal-surgery-using-preoperative-orally-administered-antibiotic-prophylaxis-precaution-study-protocol-for-a-randomized-controlled-trial
#2
Tessa Mulder, Marjolein F Q Kluytmans-van den Bergh, Anne Marie G A de Smet, Nils E van 't Veer, Daphne Roos, Stavros Nikolakopoulos, Marc J M Bonten, Jan A J W Kluytmans
BACKGROUND: Colorectal surgery is frequently complicated by surgical site infections (SSIs). The most important consequences of SSIs are prolonged hospitalization, an increased risk of surgical reintervention and an increase in mortality. Perioperative intravenously administered antibiotic prophylaxis is the standard of care to reduce the risk of SSIs. In the last few decades, preoperative orally administered antibiotics have been suggested as additional prophylaxis to further reduce the risk of infection, but are currently not part of routine practice in most hospitals...
January 19, 2018: Trials
https://www.readbyqxmd.com/read/29351772/effect-of-an-interactive-e-learning-tool-for-delirium-on-patient-and-nursing-outcomes-in-a-geriatric-hospital-setting-findings-of-a-before-after-study
#3
Elke Detroyer, Fabienne Dobbels, Andrew Teodorczuk, Mieke Deschodt, Yves Depaifve, Etienne Joosten, Koen Milisen
BACKGROUND: Education of healthcare workers is a core element of multicomponent delirium strategies to improve delirium care and, consequently, patient outcomes. However, traditional educational strategies are notoriously difficult to implement. E-learning is hypothesised to be easier and more cost effective, but research evaluating effectiveness of delirium education through e-learning is scarce at present. Aim is to determine the effect of a nursing e-learning tool for delirium on: (1) in-hospital prevalence, duration and severity of delirium or mortality in hospitalized geriatric patients, and (2) geriatric nurses' knowledge and recognition regarding delirium...
January 19, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#4
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29351055/are-pre-terms-born-timely-and-right-immunized-results-of-an-italian-cohort-study
#5
Nicola Laforgia, Antonio Di Mauro, Francesco Paolo Bianchi, Federica Di Mauro, Andrea Zizzi, Manuela Capozza, Silvia Intini, Maria Serena Gallone, Silvio Tafuri
The aim of this study is to evaluate the vaccination coverage at 24 months of chronological age in a sample of preterm infants discharged by the Neonatal Intensive Care Unit (NICU) of the Bari Policlinico University General Hospital in Italy. The list of infants preterm born discharged during 2013 by the NICU was obtained by hospital database. Vaccination status of each subject at 24 months of chronological age was acquired by the Apulian Regional Vaccination Register (GIAVA). 159 preterm borns were enrolled in this study...
January 19, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29348384/clinical-outcomes-of-geriatric-care-in-cipto-mangunkusumo-hospital-before-and-after-the-implementation-of-national-health-insurance-program
#6
Czeresna Heriawan Soejono, Retna S Padmawati, Adi Utarini
BACKGROUND: the National Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of life have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the efficiency care of this vulnarable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geriatric patients admitted to CMH between prior to and after NHI implementation...
October 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/29345003/investigation-of-attributes-which-guide-choice-in-cataract-surgery-services-in-urban-sydney-australia
#7
Celeste Gilbert, Lisa Keay, Anna Palagyi, Vu Quang Do, Peter McCluskey, Andrew White, Nicole Carnt, Fiona Stapleton, Tracey-Lea Laba
BACKGROUND: It is critical to consult patients to develop patient-centred cataract surgery care. We aimed to identify attributes patients consider when making decisions about cataract surgery in an Australian context, where both publicly and privately funded surgery are available. This is the first step in investigating how decisions are made about cataract surgery services. METHODS: This observational qualitative study was undertaken in two public hospitals and one private practice in Sydney, Australia...
January 17, 2018: Clinical & Experimental Optometry: Journal of the Australian Optometrical Association
https://www.readbyqxmd.com/read/29344355/impact-of-an-antifungal-stewardship-intervention-on-optimization-of-candidemia-management
#8
Hana Rac, Jamie L Wagner, S Travis King, Katie E Barber, Kayla R Stover
Background: Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming. Objective: To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care. Methods: This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29344339/clozapine-discontinuation-in-early-schizophrenia-a-retrospective-case-note-review-of-patients-under-an-early-intervention-service
#9
Andrew Shaker, Rowena Jones
Aim: Research in patients with treatment-resistant schizophrenia has demonstrated that clozapine discontinuation is associated with poor outcomes. There is, however, a paucity of research investigating the impact of clozapine discontinuation specifically in younger patients with more recent onset schizophrenia. A case note review was therefore conducted to ascertain medium-term prognoses in patients with treatment-resistant schizophrenia under an early intervention service (EIS) following clozapine discontinuation...
January 2018: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/29343086/percutaneous-nephrolithotomy-and-spina-bifida-complex-major-stone-surgery
#10
Stephen Mitchell, Pratik Gurung, Simon Choong, Timothy Morris, Daron Smith, Christopher Woodhouse, Timothy Philp
Background The incidence of spina bifida (SB) is approx 1:1000, and risk of stone disease is substantially raised in SB. This is the unique published study of the outcome of patients with SB undergoing percutaneous nephrolithotomy (PCNL) compared to a neurologically intact historically matched control group at the same institution. Patients and Method A series of 96 PCNLs in 13 SB and 50 non-SB control patients was analysed. The following measurements were recorded: (1) Co-morbidities; (2) Pre-operative: (renal function, American Society of Anesthesiologists (ASA) score); (3) Intra-operative: (anaesthesia time, number of tracks, stone free rate) and (4) Post-operative: (sepsis, intensive therapy unit (ITU) and total length of stay, transfusion rate, stone composition, rate of stone disease-related nephrectomy)...
January 17, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29339839/trends-in-trauma-related-mortality-among-adolescents-a-6-year-snapshot-from-a-teaching-hospital-s-post-mortem-data
#11
Sachil Kumar, Anoop K Verma
Introduction: The aim is to explore the trends in trauma mortality in children aged 0-18 years can help to co-ordinate resources toward research and programs to reduce the burden. Methods: This is a retrospective study carried out on adolescents ≤18 years of age autopsied according to the attorney request at Forensic Medicine & Toxicology department of King George's Medical University, Lucknow, India in the period from January 1st, 2009 to December 31st, 2014...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#12
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29331277/unplanned-reoperation-after-hepatectomy-an-analysis-of-risk-factors-and-outcomes
#13
Heather G Lyu, Gaurav Sharma, Ethan Y Brovman, Julius Ejiofor, Richard D Urman, Jason S Gold, Edward E Whang
BACKGROUND/PURPOSE: Reoperation is being increasingly utilized as a metric for surgical care quality. The aim of this study was to identify the incidence of and risk factors for unplanned reoperation following index hepatectomy. METHODS: Pre, intra- and post-operative information of patients who underwent partial hepatectomy in 435 hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program from 2011 to 2013 were analyzed...
January 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29330982/assessment-of-safety-levels-in-operation-rooms-at-two-major-tertiary-care-public-hospitals-of-karachi-safe-surgery-saves-life
#14
Muhammad Saeed Minhas, Muhammad Muzzammil, Jahanzeb Effendi
BACKGROUND: The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. METHODS: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330101/telephone-based-weight-loss-support-for-patients-with-knee-osteoarthritis-a-pragmatic-randomized-controlled-trial
#15
Kate M O'Brien, John Wiggers, Amanda Williams, Elizabeth Campbell, Rebecca K Hodder, Luke Wolfenden, Sze Lin Yoong, Emma K Robson, Robin Haskins, Steven J Kamper, Chris Rissel, Christopher M Williams
OBJECTIVE: To determine the effectiveness of telephone-based weight loss support in reducing the intensity of knee pain in patients with knee osteoarthritis, who are overweight or obese, compared to usual care. DESIGN: We conducted a parallel randomized controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary referral hospital in NSW, Australia. Patients with knee osteoarthritis, classified as overweight or obese (body mass index between ≥27kg/m2 and <40kg/m2) were randomly allocated to receive referral to an existing non-disease specific government funded 6-month telephone-based weight management and healthy lifestyle service or usual care...
January 9, 2018: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#16
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29327430/knowledge-attitudes-representations-and-declared-practices-of-nurses-and-physicians-about-obesity-in-a-university-hospital-training-is-essential
#17
S Bucher Della Torre, D S Courvoisier, A Saldarriaga, X E Martin, N J Farpour-Lambert
In the context of a worldwide obesity epidemic, healthcare providers play a key role in obesity management. Knowledge of current guidelines and attitudes to prevent stigmatization are especially important. This study aimed to assess knowledge, attitudes, beliefs, perception of opportunity for intervention, declared practices and need for training and material of nurses and physicians about obesity in a Swiss University Hospital. A total of 834 physicians and nurses filled an online survey. The questionnaire was based on literature, exploratory interviews and expert committee review...
January 11, 2018: Clinical Obesity
https://www.readbyqxmd.com/read/29327350/adopting-innovation-in-gynaecology-the-introduction-of-e-consult
#18
Rebecca Mann, Peter H M van de Weijer
OBJECTIVE: To describe the development of an e-consultation service as part of the triaging and grading process of referrals and to report on the efficacy and safety of such a service. METHODS: All gynaecology e-consults in the study period June 2015 to March 2016 were retrospectively reviewed. The outcomes of interest were the initial reduction in first face-to-face hospital visits, and the rate of re-referrals. Acute admission for the same reason, a subsequent diagnosis of underlying (pre)-malignancy, or patient death from the condition related to the index referral were selected as measures for patient safety...
January 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29327178/clinical-impact-and-risk-factors-for-skeletal-muscle-loss-after-complete-resection-of-early-non-small-cell-lung-cancer
#19
Shinkichi Takamori, Gouji Toyokawa, Tatsuro Okamoto, Mototsugu Shimokawa, Fumihiko Kinoshita, Yuka Kozuma, Taichi Matsubara, Naoki Haratake, Takaki Akamine, Kazuki Takada, Masakazu Katsura, Fumihiko Hirai, Fumihiro Shoji, Tetsuzo Tagawa, Yoshinao Oda, Hiroshi Honda, Yoshihiko Maehara
BACKGROUND: A relationship between sarcopenia diagnosed by skeletal muscle area (SMA) and poor prognosis in cancer patients has recently been reported. This study aimed to clarify the clinical significance of postoperatively decreased SMA in patients with early non-small cell lung cancer (NSCLC). METHODS: This study selected 101 patients with pathologic stage 1 NSCLC who had undergone pre- and postoperative (~ 1 year) computed tomography scans and lobectomy between 2005 and 2010 at Kyushu University Hospital...
January 11, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#20
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
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